Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia.
National Research and Innovation Agency, the Republic of Indonesia, Jakarta, Indonesia.
BMC Public Health. 2023 Jan 12;23(1):92. doi: 10.1186/s12889-023-15017-y.
An urban poor is a vulnerable group that needs government financing support to access health services. Once they are sick, they will fall deeper into poverty. The study aims to analyze the effectiveness of government-run insurance in hospital utilization in urban poor in Indonesia.
The research analyzed the 2018 Indonesian Basic Health Survey data. This cross-sectional survey collected 75,970 participants through stratification and multistage random sampling. Meanwhile, the study employed hospital utilization as an outcome variable and health insurance ownership as an exposure variable. Moreover, the study looked at age, gender, marital status, education, and occupation as control factors. The research employed a binary logistic regression to evaluate the data in the final step.
The results show that someone with government-run insurance is 4.261 times more likely than the uninsured to utilize the hospital (95% CI 4.238-4.285). Someone with private-run insurance is 4.866 times more likely than the uninsured to use the hospital (95% CI 4.802-4.931). Moreover, someone with government-run and private-run insurance has 11.974 times more likely than the uninsured to utilize the hospital (95% CI 11.752-12.200).
The study concluded that government-run insurance is more effective than the uninsured in improving hospital utilization among the urban poor in Indonesia. Meanwhile, private-run is more effective than government-run and uninsured in improving hospital utilization among the urban poor in Indonesia. Moreover, the most effective is to combine the kind of health insurance ownership (government-run and private-run).
城市贫困人口是一个弱势群体，需要政府的财政支持来获得医疗服务。一旦他们生病，他们将陷入更深的贫困。本研究旨在分析印度尼西亚政府经营的保险在城市贫困人口获得医疗服务方面的有效性。
本研究分析了 2018 年印度尼西亚基本健康调查数据。这项横断面调查通过分层和多阶段随机抽样收集了 75970 名参与者。同时，该研究将医院利用率作为因变量，将医疗保险的拥有情况作为暴露变量。此外，该研究还将年龄、性别、婚姻状况、教育程度和职业作为控制因素。研究采用二项逻辑回归来评估最终步骤中的数据。
研究结果表明，拥有政府经营保险的人比没有保险的人更有可能使用医院（95%置信区间 4.238-4.285），拥有私人经营保险的人比没有保险的人更有可能使用医院（95%置信区间 4.802-4.931）。此外，拥有政府经营和私人经营保险的人比没有保险的人更有可能使用医院（95%置信区间 11.752-12.200）。
研究表明，政府经营的保险比没有保险更能有效提高印度尼西亚城市贫困人口的医院利用率。同时，私人经营的保险比政府经营的保险和没有保险更能有效提高印度尼西亚城市贫困人口的医院利用率。此外，最有效的方法是结合政府经营和私人经营的医疗保险。
